COLUMN ONE

Wombs for Rent, Cheap

Surrogate mothers in India are a bargain for foreigners, and the women reap a bonanza. But some observers say they pay a price.

ANAND, India — As temp jobs go, Saroj Mehli has landed what she feels is a pretty sweet deal. It's a nine-month gig, no special skills needed, and the only real labor comes at the end -- when she gives birth.

If everything goes according to plan, Mehli, 32, will deliver a healthy baby early next year. But rather than join her other three children, the newborn will be handed over to an American couple who are unable to bear a child on their own and are hiring Mehli to do it for them.

She'll be paid about $5,000 for acting as a surrogate mother, a bonanza that would take her more than six years to earn on her salary as a schoolteacher in a village near here.

"I might renovate or add to the house, or spend it on my kids' education or my daughter's wedding," Mehli said.

Beyond the money, she said, there is the reward of bringing happiness to a childless couple in the United States, where such a service would cost them thousands of dollars more, not to mention the potential legal hassles.

Driven by many of the same factors that have led Western businesses to outsource some of their operations to India in recent years, an increasing number of infertile couples from abroad are coming here in search of women such as Mehli who are willing, in effect, to rent out their wombs.

The trend is evident to doctors such as Indira Hinduja, perhaps India's most prominent fertility specialist, who receives an inquiry from overseas every other week. It can also be detected on the Internet, where a young Indian woman recently posted an ad on a help-wanted website offering to carry a child for an expatriate Indian couple.

Then there is the dramatic example of Mehli's family. Two of her sisters have already served as surrogates -- one of them for foreigners -- and so has a sister-in-law. Mehli finally decided to join in, with the enthusiastic consent of her husband, a barber, and the guidance of a local doctor who has become a minor celebrity by arranging more than a dozen surrogacies in the last two years, for both Indian and non-Indian couples.

Some see the practice as a logical outgrowth of India's fast-paced economic growth and liberalization of the last 15 years, a perfect meeting of supply and demand in a globalized marketplace.

"It's win-win," said S.K. Nanda, a former health secretary here in Gujarat state. "It's a completely capitalistic enterprise. There is nothing unethical about it. If you launched it somewhere like West Bengal or Assam" -- both poverty-stricken states -- "you'd have a lot of takers."

Others aren't so sure about the moral implications, and are worried about the exploitation of poor women and the risks in a land where 100,000 women die every year as a result of pregnancy and childbirth. Rich couples from the West paying Indian women for the use of their bodies, they say, is distasteful at best, unconscionable at worst.

"You're subjecting the life of that woman who will be a surrogate to some amount of risk," said C.P. Puri, director of the National Institute for Research in Reproductive Health in Mumbai (formerly Bombay). "That is where I personally feel it should not become a trade."

Both sides of the debate agree that the fertility business in India, including "reproductive tourism" by foreigners, is potentially enormous. Current figures are tough to pin down, but the Indian Council of Medical Research estimates that helping residents and visitors beget children could bloom into a nearly $6-billion-a-year industry.

"It's definitely going to increase with education and literacy, especially in a country like India," said Gautam Allahbadia, a fertility specialist in Mumbai who recently helped a Singaporean couple find an Indian surrogate. He has received similar inquiries from the United States, Israel and Spain.

A Mini Baby Boom

In the vanguard of the nascent industry is this small city, where gynecologist Nayna H. Patel is presiding over a mini baby boom. But eight of her recent and imminent arrivals won't be adding to Anand's population of 100,000: Three of the infants are destined for the U.S., two for Britain and three for other parts of India. (Six more surrogacy attempts were unsuccessful.)

Before Patel's practice began attracting national and international notice, Anand was famous for decades as the milk capital of India, home to the country's most successful dairy farmer cooperative.

Now the town also boasts about 20 young women who have volunteered to be implanted with embryos at Patel's clinic. A few have already gone through the process once and are eager for a second go-round.

Prospective foreign clients hear of Patel through word of mouth or informal online networks and websites dealing with infertility issues. By the time they contact her, and spend the time, energy and money to get here, they are usually desperate for children and often emotionally battered after years of trying and failing to conceive.